By María Merino Martínez
We must pray that we may be granted a sound mind in a sound body.
Ask for a strong soul that fears not death,
That regards the time of life remaining as one of nature’s gifts,
That can endure any kind of hardship,
That knows no anger, and is free from desire
Satire X by Juvenal
A healthy mind in a healthy body
Autism is associated with an increased likelihood of developing other physical and mental health conditions. There are differences in the likelihood of developing these conditions depending on biological sex. Among the health conditions that are most common in autistic men are a greater predisposition to perinatal conditions, diseases of the skin and subcutaneous tissue, infectious diseases, and disorders of the nervous system and digestive system, whilst in women these include endocrine, nutritional and metabolic disorders, and disorders linked to the immune system; blood and haematopoietic organs (Cawthorpe, 2017).
The most common psychiatric comorbidities associated with ASD include anxiety, depression, attention deficit hyperactivity disorder, obsessive-compulsive disorder, eating disorders, social anxiety and personality disorders, amongst others (Joshi, 2013; Lugnegård, 2011). Some comorbidities have only been addressed relatively recently, or literature on them is only just beginning to emerge, such as addiction disorders, transsexuality, sexual disorders, post-traumatic stress disorder, hyperlexia, motor disorders and fibromyalgia (Merino et al, 2023)
Chronic pain in the musculoskeletal system, often associated with chronic fatigue, a feeling of not having had a proper rest, migraines, paraesthesia, problems with balance, muscle stiffness and sensitivity to temperature, is known as fibromyalgia. There is growing concern and a growing body of research linking this diagnosis to people with autism (63.4%) and hypermobility (43.7%), particularly in autistic women, as well as the presence of chronic pain in neurodivergent women (77%). The psychobiological understanding of fibromyalgia links it to alterations in the sensorimotor system and an abnormal response in pain centres. (Asztély et al., 2019; Ryan et al., 2022).
In light of this knowledge, it is important to reflect on how support and intervention are currently being approached, and to ask ourselves whether the factors that can contribute to better sensory integration are being taken into account during that crucial period represented by the early years of life—a time critical for the development of neural plasticity and the organisation of our nervous system— and whether, subsequently, we are giving due importance to nutrition and the microbiota, to sport and the organisation of our body schema, and to the reduction of chronic stress factors and the prevention of dependency, as well as to the effects that cortisol and dopamine may have in the medium and long term on all these iatrogenic effects.
People with autism face greater barriers to taking part in and developing sporting activities; factors such as group rules, competitiveness and the sensory stimuli to which they are exposed limit their ability to participate. (Duquette et al., 2016) These barriers are compounded by a scarcity of literature addressing the importance of interventions focused on the development of sporting and physical skills and, more generally, self-care; and even scarcer are studies that differentiate by gender, or studies that longitudinally link sporting, nutritional and self-care habits with a lower incidence of physical comorbidities.
With regard to the general literature on the preventive effects of regular exercise and a healthy diet in the prevention of chronic pain (Defaye et al., 2020), premenstrual syndrome (de Lima-Trostdorf et al., 2021) and premenopausal syndrome, there is ample evidence of the beneficial influence that physical activity has on reducing the intensity and symptoms associated with these hormonal events, as well as a reduced risk of developing diseases
cardiovascular (Colpani et al. 2023)
Taking care of ourselves is key to our self-concept; our physiology forms the foundation of Maslow’s hierarchy of needs. Eating well, sleeping well, and providing the body with pleasure and balance are what mammals ensure for their young, and the body upon which all our other needs depend. There is an urgent need to rethink our priorities when considering support systems and intervention models.
REFERENCES
Cawthorpe, D. (2017). Comprehensive description of comorbidity for autism spectrum disorder in a general population. Perm J, 21(16-088), 86-90. Link to Article
Ryan, L., BEER, H., Thomson, E., Philcox, E., & Kelly, C. (2023). Autistic Traits Correlate with Chronic Musculoskeletal Pain: A Self-Selected Population Based Survey. OBM Neurobiology, 7(1), 1-21. Link to Article
Asztély, K., Kopp, S., Gillberg, C., Waern, M., & Bergman, S. (2019). Chronic pain and health-related quality of life in women with autism and/or ADHD: a prospective longitudinal study. Journal of pain research, 2925-2932. Link to Article
Duquette, M. M., Carbonneau, H., Roult, R., & Crevier, L. (2016). Sport and physical activity: Facilitating interventions with young people living with an autism spectrum disorder. Physical Activity Review, (4), 40-49. Link to Article
Defaye, M., Gervason, S., Altier, C., Berthon, J. Y., Ardid, D., Filaire, E., & Carvalho, F. A. (2020). Microbiota: a novel regulator of pain. Journal of Neural Transmission, 127, 445-465. Link to Article
de Lima-Trostdorf, T. A., Moreira, E. C. H., de Oliveira, J. M. F. P., Grotti, J. E., Zago, L. C., & Macedo, C. D. S. G. (2021). Impact of physical activity and sport on the symptoms of menstrual and premenstrual periods. Journal of Womens Health and Development, 4(4), 123-135. Link to Article
Colpani, V., Oppermann, K., & Spritzer, P. M. (2013). Association between habitual physical activity and lower cardiovascular risk in premenopausal, perimenopausal, and postmenopausal women: a population-based study. Menopause, 20(5), 525-531. Link to Article